DwayneEMTP Posted January 20, 2008 Share Posted January 20, 2008 Edema of face/hands/feet? Either way I'm going to go on eclampsia as the larger life threat here...If it turns out to be sugar, the worst that's likely to happen in the short term is we'll bring down her BP a bit...(assuming all previous interventions have been accomplished IV,O2,monitor,glucose) 14/16g IV wherever we can get it... 5mg diazepam push, with 5 more standing by... 4g mag sulfate in 250mL saline to run in over 10 mins with airway support nearby... At first nonseizure moment, get a second IV (simply for redundancy), new vitals, get packaged and enroute... And hope I don't turn out to be a complete idiot... As usual I decided to post without research, so It's likely I'm completely off in the ditch here...But if so, with the exception of the diazepam/fetus interaction, I don't see where this is going to take her backwards... Dwayne Link to comment Share on other sites More sharing options...
ERDoc Posted January 20, 2008 Share Posted January 20, 2008 Still want to know about PMS, grip, to rule out stroke I doubt this is PMS, she's pregnant. Everyone is jumping to physical exam. I would focus on the history a little more. You can make 90% of your diagnoses on the history and then confirm it with the physical exam. Link to comment Share on other sites More sharing options...
ericenglund Posted January 20, 2008 Share Posted January 20, 2008 Link to comment Share on other sites More sharing options...
Fluffpaw38 Posted January 20, 2008 Share Posted January 20, 2008 (as an EMT- Sounds like maybe her appendix. What could i do? As questions. SAMPLE, Pertinent past history would be a biggy. Base line vitals Rigidity? tenderness in any of the 4 quadrants? Just the lower. (Appendix is in lower) Nasuae and headache. Airway? clear? Adequate breathing? What was she doing the say before? Could even turn out to be a poisening. Treatment: High flow oxygen. 15L via non-rebreather Transport in the position of comfort. Re-assess vitals every 5 minutes ALS otw Re-assess initial assessment if any changes Link to comment Share on other sites More sharing options...
spenac Posted January 20, 2008 Share Posted January 20, 2008 (Rigidity? tenderness in any of the 4 quadrants? Just the lower. (Appendix is in lower) My guess is that will be difficult as she is obviously pregnant, so will be hard to determine rigidity. Maybe test for positive heal strike prior to her starting to seize. Link to comment Share on other sites More sharing options...
hammerpcp Posted January 20, 2008 Author Share Posted January 20, 2008 What's heel strike? Is that a joke? Alsright so, due to pt be very edematous you can not get an IV. 1 mg of glucagon administered. What about A/w control here people? 5mg Diazepam administered rectally. Seizure stops. Sidenote no PMS or problems with PMS. Link to comment Share on other sites More sharing options...
medibrat Posted January 20, 2008 Share Posted January 20, 2008 Ok, so we've fixed the sugar and the seizure...so far anyway. NPA just in case she seizes again. Is there family around? Meds visible? Needles? What does the environment look like? does it offer any clues??? Brat :angel8: Link to comment Share on other sites More sharing options...
CBEMT Posted January 22, 2008 Share Posted January 22, 2008 First line of treatment: O2, then large bore IV, NS, D50 25g...(before she had the seizure of course). ...You saw the part about her being pregnant, right? Link to comment Share on other sites More sharing options...
hammerpcp Posted January 22, 2008 Author Share Posted January 22, 2008 ...You saw the part about her being pregnant, right? I don't see the point of this statement.....? anyhoo, the pt has now arrested. You still have no line. You see a narrow complex on the monitor at a rate of 180. Link to comment Share on other sites More sharing options...
hammerpcp Posted January 22, 2008 Author Share Posted January 22, 2008 ...You saw the part about her being pregnant, right? I don't see the point of this statement.....? anyhoo, the pt has now arrested. You still have no line. You see a narrow complex on the monitor at a rate of 180. Link to comment Share on other sites More sharing options...
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